Neural Substrates Associated with Executive Functioning in Marijuana and HIV

项目摘要 大麻是美国艾滋病毒感染者中最常见的滥用药物。1.2中的 数以百万计的美国艾滋病毒/艾滋病患者，超过一半的人患有神经认知障碍，包括智力缺陷 执行控制。先前的研究已经证明，大麻和艾滋病毒独立地破坏 在大脑的额顶“执行控制”网络中运作，白质损伤是一种 艾滋病毒相关神经病理学的组成部分。然而，大麻和艾滋病毒对大脑的相互作用 功能和结构还没有得到很好的描述。在这个成像-科学轨道奖中 研究过渡(I/START)拨款，我们建议结合多模式磁共振成像(MRI) 和神经心理评估，以测试大麻使用和艾滋病毒感染是否具有协同效应 关于神经认知障碍，特别是执行控制功能，以及大脑功能的差异 而结构与神经认知障碍有关。采用病例对照设计，我们将对60名成年人进行评估 在大麻和艾滋病毒状况方面存在分歧的四个研究小组(15个/组)。具体的目标是检查怀特 使用扩散张量成像(DTI)的物质完整性，使用静息状态功能磁共振的功能连通性 (RS-fMRI)，以及神经认知障碍与这些MRI数据之间的关系。我们的多学科 团队拥有临床心理学、认知神经科学和磁共振物理学方面的专业知识，拥有丰富的经验。 对感染艾滋病毒的吸毒者进行以患者为中心的研究，并有望成功 实施这一具有创新意义和临床重要性的项目。这项研究的首要目标是 阐明受大麻和艾滋病毒影响的大脑区域对观察到的神经认知损害有贡献 在感染艾滋病毒的大麻使用者中。此I/START赠款的结果将为后续的R01提供支持 应用于进一步研究大麻在预测神经认知功能减退患者中的作用 艾滋病毒疾病的中晚期，并测试大麻的使用频率和慢性化如何适中 结果。这项研究有很大的潜力转化为临床实践(例如，医用大麻的使用 治疗艾滋病毒相关症状和将药物滥用治疗纳入艾滋病毒护理)，并将向 开发神经生物标记物以早期识别吸毒者神经认知能力下降，与 减少许多滥用艾滋病毒的艾滋病毒感染者的艾滋病毒相关发病率和死亡率的最终目标 毒品。

Project Summary Marijuana is the most common drug of abuse among HIV-infected persons in the United States. Of the 1.2 million Americans living with HIV/AIDS, over half experience neurocognitive impairment, including deficits in executive control. Previous research has documented that marijuana and HIV independently disrupt functioning in the fronto-parietal "executive control" network of the brain, and white matter damage is an integral part of HIV-associated neuropathology. However, the interactions of marijuana and HIV on brain functioning and structure have not been well characterized. In this Imaging - Science Track Award for Research Transition (I/START) grant, we propose to combine multi-modal magnetic resonance imaging (MRI) and neuropsychological assessment to test whether marijuana use and HIV infection have synergistic effects on neurocognitive impairment, specifically in executive control functions, and how differences in brain function and structure relate to neurocognitive impairment. Using a case-control design, we will assess 60 adults across four study groups who differ on marijuana and HIV status (15/group). The specific aims are to examine white matter integrity using diffusion tensor imaging (DTI), functional connectivity using resting state functional MRI (RS-fMRI), and the relationship between neurocognitive impairment and these MRI data . Our multidisciplinary team, with expertise in clinical psychology, cognitive neuroscience, and MR physics, has extensive experience conducting patient-oriented research with HIV-infected drug users and is uniquely poised to successfully implement this innovative and clinically important project. The overarching goals of this research are to elucidate brain regions affected by marijuana and HIV that contribute to observed neurocognitive impairments in HIV-infected marijuana users. Results of this I/START grant will provide support for a subsequent R01 application to further investigate the role of marijuana in predicting neurocognitive decline in patients with early, middle, and advanced stages of HIV disease and test how frequency and chronicity of marijuana use moderate outcomes. This research has strong potential for translation to clinical practice (e.g., use of medical marijuana to treat HIV-related symptoms and integration of substance abuse treatment into HIV care) and will inform the development of neural biomarkers for early identification of neurocognitive decline in drug users, with the ultimate goal of reducing HIV-related morbidity and mortality in the many HIV-infected persons who abuse drugs.